Intraoperative Laparoscopic Fixation Sutures to Prevent Neorectal Prolapse after Transanal Total Mesorectal Excision

Despite the limited number of cases utilizing TATME approach in our center (12 patients from October 2020 to October 2021), we saw a 40% incidence of neorectal prolapse. Given our experience, we expect an increase in incidence of neorectal prolapse with growing implementation of TaTME. This is the rationale for developing the suture fixation technique to prevent the occurrence of neorectal prolapse. It is a very simple procedure to be performed intraoperatively during TaTME, which consists in fixing the colon to the left parietal pelvic peritoneum immediately after the coloanal anastomosis, by placing three absorbable stiches from the left colon just above the peritoneal reflection to the left pelvic parietal peritoneum, with no risks or complications.